Friday, October 30, 2015

How to throw the Calderstones baby out with the Winterbourne bathwater

It's good news that the government has at long last agreed to stop provision of 'care' for people with a learning disability in 'hospitals' distant from the patients homes.  The Winterbourne View scandal was years ago now and the Budd Report recommended it long ago.

It's bad news that it is to be implemented in an under resourced and careless way that will cause at least as many problems as it will solve.  See below -

If you're going to reduce services on this (or any) scale, you need to put a properly resourced alternative in place to care for and support these people.  Official warning - this is a time of "continued financial pressure" for councils who will have to pick up the bill.

You need to do it carefully.  The closure of Calderstones in Lancashire will be a very large chunk of the numbers that the government will claim towards its target of 1,300 to 1,700 in the next 3 years.  But Calderstones isn't anything like Winterbourne View.  True, the people there have learning disabilities, but 90% of them are there as a result of involvement with the criminal justice system.  They won't be going back to homes in their local community.  At best they will stay there with Calderstones rebranded in a takeover by Merseycare NHS Trust - to take it out of the official hospital numbers.  At worst, the patients will be sent (back) to prisons to be bullied and mistreated - for many, the very reason they were sent to Calderstones in the first place.  Most of calderstones is a secure institution, few of it's patients will end up in the community, but the government will claim it's hitting it's targets.

In all this, bear in mind that it wasn't the official watchdog, CQC, who raised the issue of the abuse at Winterbourne (and other places).  It was family members with support from the media.  (I don't usually like the media, but they did a good job of work on this one.)  CQC did give Calderstones a poor report and there were definitely problems.  But Calderstones was improving and got excellent reports for some of its initiatives.  Simply closing it down is a cynical piece of sleight of hand to massage the numbers and does so at the expense of the care of some of the most vulnerable (and hard to deal with) people with learning disabilities.

There isn't enough money being put aside to give good, local care in the community for the people in all the 'hospitals' that will be closed - that's partly why it's taking such an unconscionably long time.  And social care budgets are still being cut.  If we properly funded good, local care in the community, we wouldn't have remote, abusing 'hospital settings' to close down.


  1. Ned. Are your views still the same that Merseycare will re-brand and use the facilities for the same or similar services? it appears on the face of it that Merseycare are just overseeing the decommissioning of the mainly newly built units. Your thoughts please.....

  2. I need to read up more on the various players proposals before I take a considered view. And the fact that Lancashire has decided to combine with Greater Manchester and Merseyside in how it deals with the post Winterbourne View fallout - and only Manchester has published anything - complicates matters.
    My fears are that Merseycares strengths are in mental health (not much in learning disability) and there aren't clear proposals in a mega cuts context, the easy outcome will be to meet targets by rebranding rather than actual better community care. I'm not hopeful on this.